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Amlapittam treatment principles
1. AMLAPITHAM
Dr. Radhamani
Physician, Arya Vaidya Sala,
Kottakkal
Patients often prefer ayurvedic treatment for gastro intestinal
diseases. It is unofficially estimated (guestimated) that more than 25
percent of the patient population who seek ayuvedic treatment is
constituted by the sufferers of gastro intestinal diseases of which
amlapitha tops the list.
Amlapitham comprises variety of ailments resulted from the
production of gastric juice which has amlathwam (acidity) higher than
normal in concentration and quantity.
(vidahyamla gunodriktham pitham amlapitham)
Gastro intestinal tract is composed of highly dynamic population of
epithelial cells. These cells are especially capable of transmembrane
absorption and secretion. The absorptive and secretory abilities
possessed by these specialized cells facilitate digestion of food entering
the system and also the uptake of nutrients generated thereof.
Amlapitham is a disorder in, which the aforesaid secretory and absorptive
facilities are impaired.
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2. Etiology:
Amlapitham is a multi factorial disease. The etiological factors can
be broadly classified into six. It includes dietary,
O Psychological,
O Life style related,
O Seasonal,
O Regional, and
O Iatrogenic components.
Diet :
Excessive intake of sour, pungent, spicy and oily food, fermented
food items, curd, newly harvested grains, consumption of intoxicants
such as alcohol and those items which are likely to bring about an
abnormal rise in the acid level of gastric secretions. Additionally faulty
dietary habits incompatibility of food also contributes for the
development of amlapitham. Stated in terms of doshas food articles
responsible for the increase of kapha, pitha, and raktha are considered
important etiological factors.
Psychological:
Psycho, socio, familial environment leading to stress and strain,
poor stress management and emotional instabilities set a stage for the
occurrence of amlapitham.
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3. Viharam :
Viharam denotes the routine activities of an individual. Race
against time is the hallmark of modern life. It naturally ends up with
compromise on health-care activities, which are vividly enumerated in the
sasthras. The growing culture of fast food, consumerism, sedentary jobs
(computer operation), watching television for long hours, tendency to
inhibit natural urges, inadequate physical exercises are a few prominent
examples.
Seasonal :
Increased acidic content of the water and consumption of newly
harvested grains set a stage for pitha accumulation in the body during
rainy season. In fact subsequent stage of pitha vitiation (prakopa) is
prevented due to cold ambience. When the sharat ritu sets in the
ambience changes in favour of pithaprakopa.
Geographical variation:
Acharyas are of the opinion geographical variation remarkably
influence the incidence of amlapitham. More cases are reported from
anupadesa where damp atmosphere prevails althrough.
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4. Iatrogenic
Prolonged use of anti inflammatory drugs and pain killers are
found to be one of the main causes of amlapitham and subsequent
developments such as udaravranam (gastric / peptic ulcer).
Signs & symptoms
Ø Heart burn / regurgitation (thiktha amlolgaram)
Ø Epigastric pain (udarasoolam)
Ø Water brash (ulklesam)
Ø Anorexia (aruchi)
Ø Abdominal distention associated with belching, bloating, gurgling
sound. (anaham, ulgaram, adhmanam, anthrakoojanam)
Ø Chest pain (hridsoolam)
Ø Headache (siroruk)
Ø Dyspepsia (avipakam)
Ø Nausea (hrillasam)
Ø Vomiting (chardhi)
Ø Diarrhoea (vidbhedam)
Ø Heaviness in abdomen (gurukoshtathwam)
Ø Lethargy (angasadam and klamam)
Ø Horripilation (romaharsham)
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5. It as been observed that, patients suffering from leucorrhoea
(swethapradaram) have symptoms which simulate amlapitham.
Treatment
Ayurveda considers nidana parivarjanam or removal of etiological
factors as the prime step of treatment. It necessitates the individual
screening of each case in order to identify the possible causes.
Modification of life style focusing mainly on dietary schedule itself helps
to pacify the symptoms of amlapitham and eradicate the disease.
The basic therapeutic approach of ayurveda consisting of sodhana
and samana (purificatory and pacificatory) is adopted for the
management of amlapitha too. Of the sodhana therapies, virechana is
most often resorted in consideration of the site of the disease and
relatively easy practicability. Vamana (emesis), and vasthi (enema) are
usually kept in reserve to be employed in severe and complicated cases.
Nasyam and rakthamoksham have relatively little role to play in
treatment of amlapitha.
Samana chikilsa has a prominent place in the treatment profile of
amlapitha, because it is found to be more acceptable to the patient. Single
and compound drugs are selected for the treatment according to the
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6. constitution of the patient and condition of the disease. Single drugs
include yashti, dhanyakam, aswagandha, sathavari, hingu and
vishnukranthi.
O Balapunarnnavadi kashayam,
O Thiktham kashayam,
O Sukumaram kashayam
O Parooshakadi leham
O Vilwadi leham,
O Sukumara leham
O Dasamoolahareethaki leham,
O Sukumara gritham
O Dadimadi gritham
O Avipathi choornam
O Thriphaladi choornam
O Sringa bhasmam
O Swayamagni sindooram
Are a few examples of compound preparations.
For symptomatic management
O Dhanwantharam pill,
O Cheriya anthrakutaram pill,
O Sankha bhasmam
Are found effective.
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7. Diet
Non-spicy,non-oily, vegetarian diet would be ideal. Reduce chillies,
tamarind, root-vegetables, pulses, tea and coffee. Avoid pickles, unboiled
water, ice-cream, ice-cold things, fried/roasted things and those things
which are heavy for digestion. Small frequent feeds are a standard
recommendation for amlapitham. Regarding the use of milk, difference
of opinion exists among gastroenterologists.
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